Wellness Quiz

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Please select the category that best describes you:

I have have a pain, persistent pain, or something else effecting my current overall health (such as a cold.)
I have questions concerning health maintenance and/or life performance.

The best way to describe the timeline of the pain or illness you have currently?
I have had pain for three months or longer.
I have recently been injured by car, work or athletic injury.
I recently caught another person's flu or cold.
I have at least 1 headache a week or a allergies and/or cough that won't go away.
Please describe the frequency of your problem:
Aches and pains that are constant for at least 2 to 3 months and cannot be helped with anything but medication.
My pain or fever started in recent weeks and are pretty consistent since either trauma or since I fell ill.
My aches and pains come and go but they have not gone away totally for over the past 2-3 months.
Describe how your complaints effect your daily life:
For a long time now I have been struggling to focus on work/school/home life because of the pain.
I don't feel well enough to go to work or take care of the family.
I am gaining weight because I cannot be active
My back hurts so bad, I called in sick to work.

What age group are you in:
under 29
30 to 40
41 and above
If you could describe your personal health goals, what would they be?
I want to look and feel younger.
I want to lose weight.
I want to overcome any emotional blocks.
I want to stay active so I can be a better parent and/or perform better in my occupation.
What is the category that you want to exceed in?
I want to feel and look great.
I want to perform better at my job.
I want to perform better in my sport .
I want better relationships.

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